Report #2834033

Received Apr 2, 2025

Life-threateningER / ED visit

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Overview

Sex: Female
Age: 23 yrs
State: OK
Recovered: Recovered
Vaccinated: Jul 1, 2021
Onset: Jul 1, 2021
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	—	IM / RA

Symptoms (1)

Anaphylactic reaction

Symptom narrative

Anaphylaxis

Current illness

None

Medical history

Asthma, hypoglycemia, mcas

Other medications

None

Allergies

Sulfate, penicillin, latex, onion, oats